Three new dialysis providers form ESCOs in renal ACO model

The Centers for Medicare & Medicaid Services announced on Jan. 18 that it had accepted 24 new End-Stage Renal Disease Seamless Care Organizations (ESCOs) into its five-year Comprehensive ESRD Care Demonstration––including applications from three medium-sized providers.

The demonstration began in September 2015 aimed at showing whether integrated care could help improve kidney treatment and save money for the Medicare program. Based on a provider’s choice of risk model, savings shown by providers are shared between Medicare and the providers.

After getting 13 ESCOs approved in the first round with only one––Rogosin Institute––considered a small provider, CMS re-opened the application process in an effort to attract smaller- to medium-sized dialysis companies.

The 24 new sites approved by CMS to be part of the demonstration bring the number of sites in total to 37, include new ESCOs from:

The remaining 21 new ESCOs are divided between Fresenius Medical Care and Dialysis Clinic Inc., with Fresenius now at 24 sites, DaVita at three sites, and DCI now with 6 sites (see list below).

Expanding payment models

Identifying the new CEC applications from the dialysis provider community was part of a CMS announcement on Jan. 18 touting the 359,000 clinicians confirmed to participate in four of CMS’s Alternative Payment Models (APMs) in 2017. “By listening to physicians and engaging them as partners, CMS has been able to develop innovative payment reforms that bring physicians back to the core practice of medicine––caring for the patient,” said Acting Administrator Andy Slavitt.

“By reducing regulatory burden and paying for quality, CMS is offering solutions that improve the quality of services our beneficiaries receive and reduce costs, to help ensure the Medicare program is sustainable for generations to come.”

Other APMs that receive Medicare funding include The Medicare Shared Savings Program (Shared Savings Program), Next Generation Accountable Care Organization Model, and the Comprehensive Primary Care Plus (CPC+) Model. In 2017, CMS estimates that there will be:

Nephrology News & Issues covers the latest developments in nephrology and provides a forum for the exchange of ideas among the professional disciplines responsible for delivering care to the ESRD patient.